NUR 220 unit 1 pt 2

the pH of the vagina from infancy to puberty and after menopause is

Each third of the vagina is supplied by a distinct vascular and lymphatic pattern.

Vaginal lymphatics drain to what 4 nodal areas ? ( vaginal infections follow these routes )

venous anastomeses make it possible for pelvic embolism or carcinoma to bypass the heart and lungs and lodge in the brain, spine or other remote parts of the body

Lower third of the vagina is innervated by the _______ _____ and has very little somatic sensation

What are the 3 functions of the vagina?

The uterus is located:

The average measurements of a mature womans uterus is:

name 2 uterine malformations that are associated with habitual abortion:

the urinary and reproductive systems develop from the same urogenital fold in the embryo, so anomalies in one system are typically accompanied by problmes in the other

Name the 4 pairs of ligaments that support the uterus

name the 2 major parts of the uterus

The corpus of the uterus is made of mostly _______ muscle ( or _________)

The female reproductive cycle is composed of 2 different, interplaying cycles which are the ________ _________ and the _________ _________.

The ovaries secrete what 3 hormones ?? and are sensitive to what 2 hormones ??

The uterus is sensitive to what 2 hormones ?

Estrogens control what 5 things and assist in what other 2 processes.

Estrogen is highest in concentration during the proliferative (estrogenic  ) phase of the MENSTRUAL cycle

Estrogens cause the uterus to increase in size and weight due to the increase in : glycogen, amino acids, electrolytes and water  as well as blood supply

Under the influence of estrogens:
 **Uterus and fallopian tubes have increased myometrial contractility
*** Uterus becomes more sensitive to oxytocin

Estrogen:

INHIBITS FSH production
STIMULATES LH production

Estrogens can decrease the excitability of the hypothalamus --> increase in sexual desire

Progesterone is secreted by the corpeus luteum and is considered the "hormone of pregnancy " because it inhibits uterine contractions and relaxes smooth muscle ( allowing pregnancy to be maintained)

During pregnancy, the major source of progesterone secretion is the placenta

progesterone inhibits action of prolactin --> preventing lactation while pregnant

progesterone influences:

Vaginal epithelium to proliferate
cervix to secrete thick, viscous mucus
development of lobules and alveoli in breast ( lactation support )
Rise in temperature during ovulation

Prostaglandins : Oxygenated acids produced by endometrium

PGE  - relaxes smooth muscle
PGF  - vasoconstrictor and increased contractility of muscles and arteries

Prostaglandin production INCREASES during follicular maturation ( 1st part of ovarian cycle with FSH from ant. pituitary) under the influence of gonadotropins

Re: critical to follicle rupture

Follicular swelling and increased contractility of smooth muscle of theca layer of the mature follicle is caused by PGF

During late secretory phase ( last part of luteal phase when the endometrium is thickest ) the PG's ( PGF  in particular) are high because they cause vasoconstriction, limiting blood loss during the coming menstrual phase and start the ischemic phase , cutting of supply since no implantation occured

Pregnancy is counted as 280 days ( 40 weeks) from day 1 of last period.

The fertilization age ( postconception age ) is about 2 weeks less than the 40 weeks.

preembryonic stage is the 14 days from fertilization of the ovum.

Embryo stage starts at day 15 from the 1st day of last period and continues until appx 8 weeks

AT 2 -3  weeks:  2 mm ( Crown to rump)

neural tube forms
beginnig of blood circulation
tubular heart begins to form
liver begins to function
kidney formation starts
thyroid tissue appears

Week 4  = 4 - 6 mm 

Anterior portion of neural tube closes to form brain
posterior portion of neural tube closes to form spinal cord
limb buds form
tubular heart beats at appx 28 days
primitive red blood cells circulate
formation of oral cavity ( primitve jaw present)
division of esophagus and trachea begins
stomach forms

week 5  = 8 mm

C-shaped body with rudimentary tail
Brain is differentiated and cranial nerves are present
muscles have innervation
atrial division in heart has occured

Week 6 = 12 mm

primitive skeletal shape forms
ossification of skull and jaw begins
chambers of heart are present
groups of blood cells can be identified
oral and nasal cavities formed/ upper lip formed
liver begins to form red blood cells
trachea , bronchi and lung buds present
formation of external, middle and inner ear continues
embryonic sex glands appear

week 7 = 18 mm

Head is rounded and nearly erect
eyes have shifted to a more forward position
fetal heartbeat can be detected
tongue separates, palate folds , GI tract and stomach take on final form
separation of bladder and urethra from rectum
diaphragm separates abdominal and thoracic cavities
optic nerve formed, lens thickens , eyelids appear
differentiation begins into ovaries or testes

week 8 = 2.5 - 3 cm wt. 2 g

digits are formed
cartilaginous bones start to ossify
fetal movement is possible
heart development is essentially complete
rectal passage opens with perforation to anal membrane
2 circuits for fetal circulation
heartbeat can be heard with doppler at 8-12 weeks

9 -12 weeks  , 5- 8 cm / 14 - 45 g

face is well-formed
tooth buds visible
urogential tract completes development
kidneys produce urine
spontaneous movement can occur
fetal tones can be heard by doppler ( 120- 160 bpm)

age 13 - 16 weeks  =9 cm/ 55-60g-   13.5 cm / 200 g

fetus can swallow amniotic fluid, make sucking motions and produce meconium
teeth beginning to form
differentiation of hard/soft palate
development of gastric/intestinal glands/muconium in intestines
kidneys assume typical shape and organization
appearnce of scalp hair/lanugo on body
skin transparent with visible blood vessels
eyes/ears/nose are formed
sex determination is possible

20 weeks   = 19 cm / 435-465 g

lanugo covers entire body
subcutaneous brown fat ( rich blood supply)
hair on head /eyelashes,eyebrows
nails present on toes/fingers
muscles well developed
mother may feel quickening ( fetal movement)
heartbeat audible through fetoscope

24 weeks = 28 cm / 780 g ( 1 lb 10 oz )

hair is getting long
eyes are stucturally complete and will open soon
fetus has grasp reflex
skin on body is reddish and wrinkled with little body fat
footprints/fingerprints developing
vernix caseosa covers body (protective cheesecake)

25 - 28 weeks = 14 - 15 inches long/ 2 lb 10 oz - 2lb 12oz

nervous system complete enough to control body systems
eyelids open / close by neural control
lungs are immature, but capable of gas exchange
if born at this time, will require extensive care to survive and minimize handicap

29 - 32 weeks  12 - 17 inches   / 3 - 4 lbs

CNS can direct rhythmic breathing
lungs not yet mature
bones are developed but soft/flexible
fetus starts to store iron, calcium and phosphorus

35-36 weeks 17- 19 inch/ 5 -7 lbs

deposits of fat
lanugo starts to disappear
baby shows spontaneous waking at night

38 - 40 weeks  = 19 - 21 inches/ 6 - 8 lbs

skin is smooth/polished look
lanugo only present on arms/shoulders
body fills entire uterus
baby gets antibodies from mother

potential teratogen malformation

3 weeks = abscence of limbs ( ectromelia)
4 weeks = abdominal herniation into umbilical cord
                 trachea/esophogus fistula
5 weeks = eyes .
                 facial clefts
6 weeks = aortic abnormalities
7 weeks = cleft palate
                 mixed sexual characteristics
8 weeks = digital stunting ( shortness of fingers/toes)
                 persistent opening in atrial septum

spinnbarkheit

trisomies = extra chromosome

down syndrome is most common

Trisomy 21 = Down syndrome

Trisomy 18 = severe mental hypotonia , heart defects , renal defects , drooping eyes , low set ears

Trisomy 13 = seizures, severe mental hypotonia , polydactly (extra fingers) kidney ddefects, microcephaly,, heart defects

monosomy is usually incompatible with life

mosaicism = individual with 2 different cell lines
most common in sex chromosome and found in down syndrome